Provider Demographics
NPI:1154612919
Name:WOODS, DARLENE MARIE
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:MARIE
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 MCLISH ST
Mailing Address - Street 2:1058 MCLISH
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-4618
Mailing Address - Country:US
Mailing Address - Phone:580-465-9468
Mailing Address - Fax:
Practice Address - Street 1:1058 MCLISH ST
Practice Address - Street 2:1058 MCLISH
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-4618
Practice Address - Country:US
Practice Address - Phone:580-465-9468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor